Podcast 793: Atypical Toxicology Overview in SI

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">There are several online products that have been marketed towards individuals with SI</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Sodium nitrite</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Food preservative that can cause methemoglobinemia when ingested in large amounts</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Patients present with blue skin discoloration and severe respiratory distress</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Treat with methylene blue to reduce methemoglobin back to hemoglobin</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Formic acid and sulfuric acid </span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">These two acids can be combined in a confined space to create a potentially lethal exposure to carbon monoxide</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Patients present with symptoms of CO poisoning as well as possible chemical burns and inhalation injuries</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Patients require decontamination and treatment for CO poisoning in the emergency department</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Hydrogen sulfide</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Toxic gas that is produced from combining strong acid (toilet bowl cleaner) and a sulfur containing product (selenium sulfide shampoo and sulfa drugs)</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">“Knock down